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European Respiratory Journal 07/30/2020 10:01
Background. There is insufficient information about risk factors for COVID-19 diagnosis and adverse outcomes from low and middle-income countries (LMICs). Objectives. We estimated the association between patients’ characteristics and COVID-19 diagnosis, hospitalisation and adverse outcome in Mexico. Methods. This retrospective case series used a publicly available nation-level dataset released on May 31, 2020 by the Mexican Ministry of Health, with patients classified as suspected cases of viral respiratory disease.
European Respiratory Journal 07/30/2020 10:01
Coronaviruses have been known to cause respiratory infections in humans and intestinal infections in other mammals. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes COVID-19, is the 7th virus of the Coronaviridae family that is known to infect humans. Until 2002, four Coronaviruses infecting humans were described (HCoV- NL63, HCoV-229E, HCoV- OC43 and HKU1). These viruses caused only mild respiratory diseases in immunocompetent hosts. Since 2002, three highly pathogenic viruses from this family have been identified. SARS-CoV (also referred to as SARS-CoV-1) is an enveloped, positive-sense, single-stranded RNA virus which infects the epithelial cells within the lungs. The virus enters the host cell by binding to ang.
European Respiratory Journal 07/30/2020 10:01
Background. Early and accurate diagnosis of interstitial lung diseases (ILDs) remains a major challenge. Better non-invasive diagnostic tools are highly needed. We aimed to assess the accuracy of exhaled breath analysis using eNose technology to discriminate between ILD patients and healthy controls, and to distinguish ILD subgroups. Methods. In this cross-sectional study, exhaled breath of consecutive ILD patients and healthy controls (HCs) was analysed using eNose technology (SpiroNose). Statistical analyses were done using Partial Least Square Discriminant Analysis (PLS-DA) and Receiver Operating Characteristic (ROC) analysis. An independent training and validation set (2:1) was used in larger subgroups. Results. A total of 322 ILD patients.
European Respiratory Journal 07/30/2020 10:01
Purpose. HIV infection is an exclusion criterion in lung cancer trials. This multicenter phase II trial aimed to assess feasibility, efficacy and safety of first-line carboplatin plus pemetrexed (CaP) followed by pemetrexed ℗ maintenance in people living with HIV (PLHIV) with advanced non-squamous non-small cell lung cancer (NS-NSCLC). Methods. Four cycles of CaP were followed by P-maintenance therapy in patients with Eastern Cooperative Oncology Group performance status (PS) ≤2. The primary objective was a disease control rate (DCR) ≥30% after 12 weeks. Results. Of the 61 PLHIV enrolled 49 (80%) had a PS 0–1, 19 (31%) brain metastases. Median CD4 lymphocyte count was 418 cells·µL –1 (range: 18–1230), median CD4 lymphocyte nadir 169.5 cells·µL.
European Respiratory Journal 07/30/2020 10:01
The EarlyCDT-Lung test is a high specificity blood-based autoantibody biomarker that could contribute to predicting lung cancer risk. Here we report on the results of a phase IV biomarker evaluation of whether using the EarlyCDT-Lung test and any subsequent CT scanning to identify those at high risk of lung cancer reduces the incidence of patients with stage III/IV/Unspecified lung cancer at diagnosis, compared with the standard clinical practice at the time the study began. ECLS was a randomised controlled trial of 12 208 participants at risk of developing lung cancer in Scotland. The intervention arm received the EarlyCDT-Lung test and, if test positive, low-dose CT scanning six-monthly for up to 2 years. EarlyCDT-Lung test negative and c.
European Respiratory Journal 07/30/2020 10:01
We are interested in an article published in the journal recently, entitled "The potential impact of COVID-19-related disruption on tuberculosis (TB) burden". The study used a mathematical model to estimate the relative impact of reductions in social contacts and health services on TB burden due to the COVID-19 epidemic. There included data and projections on China, being one of 22 high TB burden countries for both TB and multidrug resistant TB cases. COVID-19, which has spread rapidly and enveloped most of the world, is a unique global public health crisis for the century. By the end of January 2020, The World Health Organization declared COVID-19 outbreak a global health emergency and called for moves to stop the transmission of this viru.
European Respiratory Journal 07/30/2020 10:01
Background. Asthma is a heterogeneous and complex disease, and the description of asthma phenotypes based on extrapulmonary treatable traits has not been previously reported. Objective. to identify and characterise clusters based on clinical, functional, anthropometrical, and psychological characteristics in participants with moderate-to-severe asthma. Methods. This is a cross-sectional multicentre study involving centres from Brazil and Australia.
European Respiratory Journal 07/30/2020 10:01
Large-conductance, Ca 2+ -activated, voltage-dependent K + (BK) channel function is critical for adequate airway hydration and mucociliary function. In airway epithelia, BK function is regulated by its subunit leucine-rich repeat-containing protein 26 (LRRC26). Since patients with cystic fibrosis (CF)-related diabetes mellitus (CFRD) have worse lung function outcomes, this study determined the effects of hyperglycaemia on BK function in CF bronchial epithelial (CFBE) cells in vitro and evaluated the correlation between glycaemic excursions and mRNA expression of LRRC26 in the upper airways of CF and CFRD patients. CFBE cells were re-differentiated at the air-liquid interface (ALI) in media containing either 5.5 mM or 12.5 mM glucose. BK act.
European Respiratory Journal 07/30/2020 10:01
Cystic fibrosis transmembrane conductance regulator (CFTR) modulators are the first approved drugs targeting underlying epithelial ion/fluid transport defects in patients with cystic fibrosis (CF). Current CFTR modulators restore mutant CFTR activity to up to ~50% of normal CFTR Cl – channel function, translating into improvements in percentage predicted FEV 1 and other clinical outcomes. In addition, reductions in airway bacterial colonisation are observed; however, patients fail to eradicate bacteria over time and still experience pulmonary exacerbations, and long-term safety of CFTR modulator therapy remains unknown. Currently approved CFTR modulators are predicted to be effective for up to 90% of patients. A mutation-agnostic approach c.
European Respiratory Journal 07/30/2020 10:01
Background. Viral respiratory infections are the main causes of asthma exacerbation. The susceptibility of asthmatics to develop an exacerbation when they present with severe pneumonia due to SARS-CoV-2 infection is unknown. The objective of this study was to investigate the characteristics and outcomes of asthmatic patients with COVID-19 pneumonia who required hospitalisation during the spring 2020 outbreak in Paris, France. Methods. A prospective cohort follow-up was carried out from March 15 to April 15, 2020 in Bicêtre Hospital, University Paris-Saclay, France. All hospitalised patients with a SARS-CoV-2 infection who reported a history of asthma were included. Results. Among 768 hospitalised patients, 37 (4.8%) reported a history of asthm.
European Respiratory Journal 07/30/2020 10:01
Whole genome sequencing (WGS) can be used for molecular typing and characterisation of Mycobacterium tuberculosis complex (MTBC) strains. We evaluated the systematic use of a WGS-based approach for MTBC surveillance involving all European Union/European Economic Area (EU/EEA) countries and highlight the challenges and lessons learned to be considered for the future development of a WGS-based surveillance system. WGS and epidemiological data of patients with rifampicin (RR) and multi-drug resistant (MDR)-tuberculosis (TB) were collected from EU/EEA countries between January 2017 and December 2019. WGS-based genetic relatedness analysis was performed using a standardised approach including both core genome multilocus sequence typing (cgMLST),
European Respiratory Journal 07/30/2020 03:45
Numerous cases of e-cigarette, or vaping, associated lung injury (EVALI) have recently prompted an investigation of the outbreak in the USA [1]. Only two non-fatal cases have been reported so far in Europe: one case of hypersensitivity pneumonia in the UK after the use of flavoured e-cigarette liquid by a young adolescent [2], and one US imported case recently described in Spain [3]. To our knowledge, this is the first report of a fatal EVALI case in Europe.
European Respiratory Journal 07/30/2020 03:45
Inflammation is a key feature in the pathogenesis of sepsis and acute respiratory distress syndrome (ARDS). Sepsis and ARDS continue to be associated with high mortality. A key contributory factor is the rudimentary understanding of the early events in pulmonary and systemic inflammation in humans, which are difficult to study in clinical practice, as they precede the patient's presentation to medical services. Lipopolysaccharide (LPS), a constituent of the outer membrane of Gram-negative bacteria, is a trigger of inflammation and the dysregulated host response in sepsis. Human LPS models deliver a small quantity of LPS to healthy volunteers, triggering an inflammatory response and providing a window to study early inflammation in humans. T.
European Respiratory Journal 07/30/2020 03:45
Objective. To evaluate the effect of aerobic exercise training on asthma control, lung function and airway inflammation in adults with asthma. Design. Systematic review and meta-analysis. Methods. Randomised controlled trials investigating the effect of ≥8 weeks of aerobic exercise training on outcomes for asthma control, lung function and airway inflammation in adults with asthma were eligible for study.
European Respiratory Journal 07/30/2020 03:45
Cystic fibrosis (CF) is a monogenetic disorder of the CFTR gene that has traditionally been associated with Caucasian people. While accounts of syndromes, likely caused by CF, have been identified dating back to the 16th century, the physiological basis of the disease at the cellular and genetic levels was not clarified until the 1980s [1, 2]. Since that time over 2000 mutations in the CF transmembrane conductance regulator (CFTR) have been identified [3]. While the majority (~80%) of patients are diagnosed within the first 2 years of life, about 10% of patients present in adulthood, and some patients present at an advanced age [4].
European Respiratory Journal 07/30/2020 03:45
The catastrophic impact of the coronavirus disease 2019 (COVID-19) epidemic in Italy has previously been described [1, 2]. In a recent editorial, Nava et al. [3] paid a well-deserved tribute to the almost 200 healthcare workers who succumbed to COVID-19 in the country in less than 3 months since the first case was reported. We would like to contribute with some considerations on the shortcomings of Italy's response to the pandemic.
European Respiratory Journal 07/30/2020 03:45
At the end of last year, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in an acute respiratory illness epidemic in Wuhan, China [1, 2]. The World Health Organization (WHO) termed this illness coronavirus disease 2019 (COVID-19). The coronavirus family have been shown to enter cells through binding angiotensin-converting enzyme 2 (ACE-2), found mainly on alveolar epithelium and endothelium. Activation of endothelial cells is thought to be the primary driver for the increasingly recognised complication of thrombosis.
European Respiratory Journal 07/30/2020 03:45
Venous thromboembolism (VTE) is a well-known complication in hospitalised patients [1–5]. Risk factors include older age, obesity, immobilisation, active malignancy, systemic inflammatory response syndrome (SIRS), (major) surgery, thrombophilia and a history of thromboembolism [2, 5]. In 1884, Rudolph Virchow first described the underlying pathophysiological mechanisms, which consist of endothelial cell dysfunction/inflammation, low blood flow and blood hypercoagulability. Current guidelines recommend the use of thromboprophylaxis in acutely ill medical patients who are at high risk for VTE (Padua score ≥4, IMPROVE (International Medical Prevention Registry on Venous Thromboembolism) score ≥2) [6]. However, in medical practice, less than ha.

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